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Meta-Analysis
. 2016 Dec;51(12):1512-1519.
doi: 10.1080/00365521.2016.1216588. Epub 2016 Aug 10.

Preoperative transarterial chemoembolization for resectable hepatocellular carcinoma in Asia area: a meta-analysis of random controlled trials

Tengfei Si  1 , Yongjun Chen  1 , Di Ma  1 , Xiaoyong Gong  1 , Kui Yang  1 , Ruoyu Guan  1 , Chenghong Peng  1
Affiliations
Meta-Analysis

Preoperative transarterial chemoembolization for resectable hepatocellular carcinoma in Asia area: a meta-analysis of random controlled trials

Tengfei Si et al. Scand J Gastroenterol. 2016 Dec.

Abstract

Objective: We aimed to systematically evaluate the influence of preoperative transarterial chemoembolization (TACE) for resectable hepatocellular carcinoma (HCC) on long-term prognosis and perioperative safety.

Materials and methods: Databases including PubMed, Embase, Cochrane, Wanfang, CNKI, VIP data were searched, combined with Manual Retrieval and Cited Reference Search to collect the published randomized controlled trial (RCT) about the influence of pre-TACE for curative resection of HCC. The searching cutoff date was 2016/02/25, all the data obtained were statistically analyzed using RevMan5.2 software recommended by Cochrane Collaboration.

Results: A total of 5 RCT including 430 (pre-TACE group: 212, surgery alone group: 218) patients were included. The results of meta-analysis showed that: there was no difference between the 2 groups on overall survival (OS) rate [HR 1.25, 95%CI (0.92-1.68)], disease free survival (DFS) rate [HR 0.95 (0.76-1.19)], perioperative mortality rate [OR 0.70 (0.22-2.30)], or blood loss [SMD 0.07 (-0.14-0.29)], whereas the subgroup analysis revealed that pre-TACE would result in longer operation time [SMD 0.31 (0.06-0.57)], higher postoperative morbidity rate [OR 1.90 (1.02-3.53)] and combined resection rate of perihepatic organs [OR 5.46 (2.73-11.78)] in subgroup with mean tumor diameter >5cm.

Conclusions: According to our study, pre-TACE treatment cannot improve the long-term prognosis of resectable HCC. With the growth of the tumor diameter, especially when it is over 5cm, it might add difficulties to surgery and affect the perioperative safety.

Keywords: Hepatocellular; meta-analysis; resectable; transarterial.

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Figures

Figure 1.
Figure 1.
The flowchart of the study screening and the detailed selection process.
Figure 2.
Figure 2.
(A) Forest plot of the subgroup analysis on the DFS. (B) Forest plot of the subgroup analysis on the OS.
Figure 3.
Figure 3.
(A) Forest plot of the subgroup analysis on the perioperative mortality. (B) Forest plot of the subgroup analysis on the postoperative morbidity
Figure 4.
Figure 4.
(A) Forest plot of the subgroup analysis on the blood loss. (B) Forest plot of the subgroup analysis on the operation time
Figure 5.
Figure 5.
Forest plot of the subgroup analysis on the combined resection of perihepatic organs.
Figure 6.
Figure 6.
The funnel plot for overall disease-free survival of the included studies.
See this image and copyright information in PMC

References

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